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Effect of transcutaneous auricular vagus nerve stimulation combined with robot-assisted therapy on upper limb function of stroke patients
ZHENG Li, BAO Zhicheng, ZHANG Qi, REN Xuyan, SU Min
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (6): 691-696.   DOI: 10.3969/j.issn.1006-9771.2023.06.009
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Objective To investigate the effect of transcutaneous auricular vagus nerve stimulation (taVNS) combined with robot-assisted therapy on upper limb function of subacute stroke patients.
Methods From March, 2022 to March, 2023, 60 subacute stroke patients from Dushu Lake Hospital and the First People's Hospital of Kunshan were randomly divided into control group (n = 20), robot group (n = 20) and combined group (n = 20). All the groups received conventional treatments including medication, physical therapy and occupational therapy; the robot group received sham taVNS combined with hand robot-assisted therapy; while the combined group received taVNS combined with hand robot-assisted therapy, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and hand part, the root mean square (RMS) electromyography of the extensor carpi radialis and extensor digitorum muscles during contraction, and the latency and amplitude of transcranial magnetic stimulation motor-evoked potential (TMS-MEP) before and after treatment.
Results After treatment, the scores of FMA-UE and hand part, RMS of the extensor carpi radialis and extensor digitorum muscles, and latency and amplitude of TMS-MEP improved in all the groups (t > 2.099, P < 0.05); and they were the best in all indicators in the combined group (F > 9.106, P < 0.001).
Conclusion taVNS combined with robot-assisted therapy can promote central nervous system remodeling and further improve upper limb function in stroke patients.

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Chinese Journal of Rehabilitation Theory and Practice    2025, 31 (1): 70-84.   DOI: 10.3969/j.issn.1006-9771.2025.01.007
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Exercise intervention for spinal curvature abnormality in children and adolescents: a bibliometrics analysis
LI Xuan, DOU Peng, WANG Xuanchao, JIANG Haimei, RAO Jingyi, QIAN Shuping, WANG Chuhuai, XU Yi
Chinese Journal of Rehabilitation Theory and Practice    2024, 30 (10): 1140-1150.   DOI: 10.3969/j.issn.1006-9771.2024.10.004
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Objective To analyze the hotspots and frontiers of researches related to exercise intervention for spinal curvature abnormalities in children and adolescents.

Methods Articles related to exercise intervention for spinal curvature abnormalities in children and adolescents were retrieved from CNKI and Web of Science Core Collection, from January, 2014 to December, 2023. The literatures were analyzed wtih CiteSapce 6.2.R3 in terms of disciplines, countries, institutes and keywords.

Results A total of 233 articles were retrived, including 71 articles in Chinese and 162 articles in English. The annual publication volume was on the rise. China was the country with the highest number of publications. South Korea was seen a sudden increase in recent literature. For Chinese, the institutions with the largest number of publication were the Department of Health and Exercise Science in Tianjin University of Sport and Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital). While the institutions with the largest number of publication in English were Marmara University and Hong Kong Polytechnic University. The English literatures covered a wide range of disciplines, including clinical medicine, sports medicine, neurology and psychology. Common high-frequency keywords in both Chinese and English literatures were idiopathic scoliosis, Cobb's angle and Schroth exercise. The latest bursting words included physical health in Chinese, and health-related quality of life and respiratory muscle strength in English.

Conclusion The research popularity related to exercise intervention for spinal curvature abnormality in children and adolescents is generally on the rise. The research hotspots focus on four main areas: disease, quality of life, research advances and clinical treatment. More attention should be paid to the effect and dosage of exercise intervention on the respiratory function, as well as the effect of Chinese medicine exercise therapy on pediatric patients with abnormal spinal curvature diseases. Future work should focus on constructing an evidence-based Chinese/Western medicine exercise prevention and treatment system in the context of China's national conditions, advancing high-quality randomized controlled trials, strengthening interdisciplinary and international collaborations, and focusing on the development and evaluation of personalized exercise intervention programs.

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Chinese Journal of Rehabilitation Theory and Practice    2025, 31 (1): 67-69.   DOI: 10.3969/j.issn.1006-9771.2025.01.006
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Structure, content and psychometric properties of physical activity measurement/reporting tools applicable to children and adolecents with disabilities: a systematic review
SHI Xiaoyu, YANG Jian
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (6): 621-629.   DOI: 10.3969/j.issn.1006-9771.2023.06.001
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Objective To synthesize the structure, content and psychometric properties of physical activity measurement/reporting tools applied in children and adolescents with disabilities.
Methods Literature on physical activity measurement/reporting tools for children with disabilities were retrieved from PubMed, Medline, EBSCO, Web of Science and CNKI, from establishment to June, 2023. The main structure and content characteristics of the tools were analyzed using the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). The psychometric properties of the tools was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN).
Results Six tools were selected, and nine papers were finally included. Two tools were globalized standard tools, namely Global Matrix 4.0 Physical Activity Report Card for Children and Youth (Global Matrix 4.0) and the Global Matrix of Para Report Card on Physical Activity of Children and Adolescents with Disabilities (Para Report Card), measuring b455 functions of motor tolerance function, b7 neuromusculoskeletal and motor-related functions; d4 mobility, d450 walking, d470 using transportation, d820 school education, d910 community life, d920 recreation and leisure; e310 immediate family, e320 friends, e460 societal attitudes, and e575general social support services, systems and policies, etc. These tools showed a complete structure, high reliability, validity and feasibility, and could be performed in a self-reported manner or completed by the custodian or school teacher. The International Physical Activity Questionnaire (IPAQ) might measure d4 mobility, d450 walking, d640 doing housework, d820 school education, d920 recreation and leisure. IPAQ was good in terms of internal consistency, content and construct validity, and cross-cultural validity, with different test-retest reliability and hypothesis testing results reported in different applied studies. Children and Adolescents Physical Activity and Sedentary-Questionnaire (CAPAS-Q) might measure the d4 mobility, d450 walking, d470 using transportation, d820 school education, and d920 recreation and leisure. CAPAS-Q was good in internal consistency, retest reliability, content and construct validity, but hypothesis testing results and cross-cultural validity were unknown. Physical Activity Questionnaire for Older Children (PAQ-C) and Physical Activity Questionnaire for Adolescents (PAQ-A) might measure d4 mobility, d450 walking, d470 using transportation, d820 school education, and d920 recreation and leisure. PAQ-C and PAQ-A were strong in internal consistency, retest reliability, content and construct validity, and cross-cultural validity, without hypothesis testing results.
Conclusion In terms of content, Para Report Card is the most comprehensive and extended physical activity measurement/reporting tool for children and adolescents with disabilities. In terms of the psychometric properties of the instruments, the multidimensional, structured physical activity measures show high internal consistency, retest reliability, and content and construct validity, with varying retest reliability and correlational validity with objective measures across studies.

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Effect of short-foot exercise on adult flatfoot: a systematic review
YU Zhongqi, WANG Chao, HE Gang, ZHANG Liang, WANG Ruiyan
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (5): 551-557.   DOI: 10.3969/j.issn.1006-9771.2023.05.009
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Objective To systematically review the effects of short-foot exercise on adult flatfoot.

Methods Articles related to short-foot exercise for flatfoot were searched from PubMed, Web of Science, Cochrane, Embase, Scopus, CNKI, Wanfang Data and CBM, from January, 2010 to December, 2022. The methodological quality was evaluated with the Physiotherapy Evidence Database (PEDro) scale, and the relevant data were extracted.

Results Ten randomized controlled trials were included, involved 335 individuals. The mean score of the PEDro scale was 7.1. Short-foot exercise improved the navicular drop, posture index score, balance and cross-sectional area of abductor hallucis muscle for patients with flatfoot, but plantar pressure.

Conclusion Short-foot exercise can improve the foot structure, balance and adductor hallucis muscle in adult flatfoot, but plantar pressure.

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Speech and language rehabilitation services for children with hearing impairment based on ICF: theoretical framework and service system
ZHOU Jing, YI Ling, CHEN Jianchao, CHEN Xuefen, WEI Xingxing, CHEN Jingjing
Chinese Journal of Rehabilitation Theory and Practice    2024, 30 (7): 745-751.   DOI: 10.3969/j.issn.1006-9771.2024.07.001
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Objective Based on the bio-psycho-social model of functioning and health of International Classification of Functioning, Disability and Health (ICF) framework, this paper systematically analyzes rehabilitation-related policy documents of the World Health Organization (WHO) to explore the theoretical and policy principles, service systems, priority development areas, and main policy and technical measures for speech and language rehabilitation for children with hearing impairment.
Methods Under literature research and policy analysis methods, this paper systematically reviewed the functioning and health framework of ICF, relevant WHO policy reports and American Speech and Hearing Association technical documents, analyzed the current status and needs of rehabilitation services in China, and proposed a theoretical framework, priority areas, and main policy and technical measures for constructing an ICF-based speech and language rehabilitation service system for children with hearing impairment.
Results There were eight major principles for the development of speech and language rehabilitation for children with hearing impairment: child-centered and respect for individual differences, life-cycle support and promoting continuous development, evidence-based practice, multidisciplinary collaboration, building family participation support networks, promoting integrated education and social participation, focusing on cultural sensitivity, and technology-empowered rehabilitation innovation. Five service systems were elaborated, including comprehensive early screening, diagnosis, and intervention system; family and social support system; multidisciplinary team services system; comprehensive, multi-level speech and language rehabilitation service system; and digitally empowered services to build new rehabilitation service models. The priority development areas, and main policy and technical measures for speech and language rehabilitation for children with hearing impairment were also discussed.
Conclusion Based on the bio-psycho-social model of functioning and health of ICF, comprehensive, personalized, continuous, high-quality and universally accessible speech and language rehabilitation services can be developed by implementing measures, such as strengthening policy support, improving service systems, cultivating multidisciplinary professionals, promoting digital empowerment technologies and enhancing support system, to promote the overall development, social participation and quality of life for children with hearing impairment.

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Effect of rhythmic physical activity on executive function in children aged three to six: a systematic review
DU Anlong, NING Ke, SHANGGUAN Chunzi, WANG Chen, ZHANG Jingjie, QIAO Siying, LI Zhangtao
Chinese Journal of Rehabilitation Theory and Practice    2024, 30 (11): 1334-1342.   DOI: 10.3969/j.issn.1006-9771.2024.11.011
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Objective To systematically analyze the effect of rhythmic physical activity on executive function and sub-components in healthy preschool children.

Methods Literature in Chinese and English was retrieved from databases such as CNKI, Wanfang Data, EBSCO, PubMed, Google Scholar and Web of Science for researches about the intervention of rhythmic physical activity for executive function of healthy children aged three to six years, up to October, 2024. The methodological quality of the researches was evaluated with PEDro Scale, and data were extracted for a systematic review.

Results Ten researches, published between 2019 and 2024, from seven countries, were included; and seven were randomized controlled trials and three were quasi experiment, involving a total of 1 047 children. The scores of the PEDro scale ranged five to eight. The rhythmic physical activity intervention was 20 to 50 minutes a time, one to five times a week, for six to 20 weeks. The forms of rhythmic physical activity intervention included sports activities (street dance, flower ball cheerleading, walking, running, jumping and other motor skill exercises), music teaching activities (music perception, rhythm synchronization and music games), dance activities (creative dance, action imitation and role playing) and music performance activities (body percussion, rhythm sticks, sand balls and drums). Rhythmic physical activity was effective on at least one sub-component of executive function. However, five of the seven researches involving cognitive flexibility failed to demonstrate a positive effect. Six researches compared the effects of rhythmic physical activity versus other physical activities, and five found that rhythmic physical activity was more effective on executive function.

Conclusion Rhythmic physical activity can improve inhibitory control and working memory in preschool children; but the effect on cognitive flexibility remain controversial.

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Effect of music therapy on post-stroke cognitive impairment
LIN Yufan, WEI Tianyuan, ZHANG Xiaoying, LI Chaojinzi, HE Jingjie, DU Xiaoxia
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (6): 714-719.   DOI: 10.3969/j.issn.1006-9771.2023.06.013
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Objective To observe the effect of music therapy on cognitive function, motor function, and activities of daily living (ADL) of patients with post-stroke cognitive impairment.
Methods From December, 2020 to July, 2022, 48 patients with post-stroke cognitive impairment in Beijing Bo'ai Hospital were enrolled and randomly divided into control group (n = 24) and experimental group (n = 24). Both groups received conventional medication, nursing, and conventional rehabilitation, while the experimental group received music therapy additionally, for eight weeks. Before and after intervention, the cognitive function was assessed by Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and motor function and ADL were assessed with Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI), respectively.
Results Six cases in the control group dropped down. The increase in the scores of LOTCA and FMA was more in the experimental group than in the control group (t > 2.665, P < 0.05), however, no significant difference was found in the increase of MBI score between two groups.
Conclusion Music therapy could improve the cognitive function and motor function of patients with post-stroke cognitive impairment.

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Effect of acute physical activity on cognitive function in children: a systematic review
JIANG Changhao, GAO Xiaoyan
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (6): 667-672.   DOI: 10.3969/j.issn.1006-9771.2023.06.006
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Objective To evaluate the effects of physical activity on children's cognitive function based on International Classification of Functioning, Disability and Health (ICF).
Methods The PICO framework was constructed. Trials on the effects of physical activity on children's cognition were searched in Web of Science, PubMed, ProQuest and CNKI from inception to June 1st, 2023. The included literature was evaluated for methodological quality using the Physiotherapy Evidence Database (PEDro) scale.
Results Ten papers from six countries with a total of 550 subjects were involved, including both healthy children and children with attention deficit and hyperactivity disorders. Physical activity involved running, cycling, high jumping, jumping rope and soccer, and the type of physical activity was acute aerobic exercise, ranging from twelve to 30 minutes, mostly at moderate intensity. Health outcomes were focused on cognitive aspects.
Conclusion A theoretical framework for the benefits of physical activity on children's cognitive function has been constructed based on ICF. Acute physical activity shortens reaction time, improves various subcomponents of executive function, increases selective attention, and consolidates long-term memory.

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Mental health services for children with intellectual and developmental disabilities: a WHO-FICs-based study
WANG Shaopu, YANG Yaru, QIU Zhuoying, YANG Jian, YAO Meilin, SUN Hongwei, ZOU Min
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (9): 993-1003.   DOI: 10.3969/j.issn.1006-9771.2023.09.001
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Objective To systematically analyze the typical mental health conditions and psychological disorders of children with intellectual and developmental disabilities (IDD), to construct a mental health service system and psychological interventions to these mental health conditions of children with IDD.

Methods Based on the framework of the World Health Organization Family International Classifications (WHO-FICs), the mental health conditions and related functioning were analyzed, and the mental health service framework and proposed mental health interventions were constructed.

Results There were six main categories of mental health conditions for children with IDD: mood disorders (anxiety and depression), behavioral disorders (disruptive disorders and challenging behaviors, aggressive behaviors), traumatic disorders (post-traumatic stress disorder), mental disorders (schizophrenia), suicide and self-harm, and learning disabilities (developmental learning disabilities, attention deficit hyperactivity disorder). Mental health services for children with IDD involved in six dimensions: leadership and governance, fundraising, human resources, service delivery, mental health technologies, and information and research. Mental health services went through the continuum of health services from prevention, treatment, rehabilitation to health promotion. We delivered mental health services for children with IDD in three aspects: identifying and diagnosing mental health problems or conditions, analyzing the main factors caused mental health problems, and analyzing the environmental factors. Mental health service interventions mainly covered five categories: antidepressants, psychotherapy, stress management training, physical exercise training, healthy lifestyle education, consultation and support. Children with IDD may obtain the mental health services in hospitals, rehabilitation institutions, community and school settings.

Conclusion This study systematically analyzed the typical mental health status and related psychological functional impairments of children with IDD. Based on the World Health Organization health service system, a mental health service framework for children with IDD was constructed. Referring to the WHO's continuum of health services, a system of psychological intervention methods for children with IDD was established. Furthermore, the WHO-FICs were used to describe and code the functions of children with IDD, and the ICHI-β3 was applied to code and analyze the related psychological interventions.

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Effect of repetitive facilitative exercise on hand function of stroke patients with hemiplegic during recovery period
GU Bin, ZHANG Jinqin, XIA Yuanhao, HU Jingran, NAOKI Morohashi, HUANG Fubiao
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (6): 697-702.   DOI: 10.3969/j.issn.1006-9771.2023.06.010
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Objective To observe the effect of repetitive facilitative exercise (RFE) on the hand function of stroke patients with hemiplegia during recovery period.
Methods From January to December, 2022, 80 stroke patients with hemiplegia following hand dysfunction during recovery period in Beijing Bo'ai Hospital were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation, the control group added functional occupational therapy, and the experimental group added RFE, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Simple Test for Evaluating Hand Function (STEF) and modified Barthel Index (MBI) before and after treatment.
Results One case dropped down in the experimental group. After treatment, all the scores increased in both groups (|t| > 12.698, P < 0.001), and were better in the experimental group than in the control group (|t| > 2.302, P < 0.05).
Conclusion RFE could promote the recovery of hand function and activities of daily living in patients with hemiplegia during stroke recovery period.

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Construction of basic rehabilitation training course for family doctor teams serving for people with disabilities based on WHO rehabilitation competency framework
YANG Xiulian, QIN Jian, XIAN Yuantao, LIU Hongliang, YANG Yaru, XIANG Youyu, LUO Jie, ZHONG Shixun, ZHONG Yu, ZHOU Sujun, SU Hong, XIAO Hongmei, ZHOU Xinjian
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (11): 1249-1260.   DOI: 10.3969/j.issn.1006-9771.2023.11.002
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Objective To develop basic training courses for family doctor teams for people with disabilities.

Methods Utilizing the methods and theories of the World Health Organization (WHO) rehabilitation competency framework (RCF), and referring to the WHO universal health coverage global competency framework, the rehabilitation competency characteristics of family doctor teams for people with disabilities in community settings were analyzed, and a basic training course system for these teams based on the RCF was developed.

Results and Conclusion Based on RCF, a competency framework for family doctor teams serving people with disabilities has been constructed. The objectives, content and training course system for basic rehabilitation training has been established.

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Effect of high-intensity interval training on executive function for healthy children and adolescents: a systematic review
WANG Junyu, YANG Yong, YUAN Xun, XIE Ting, ZHUANG Jie
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (9): 1012-1020.   DOI: 10.3969/j.issn.1006-9771.2023.09.003
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Objective To systematically review the effect of high-intensity interval training (HIIT) on executive function for healthy children and adolescents, and delineate the factors related to the intervention outcome.

Methods Literature about the effect of HIIT on executive functions for healthy children and adolescent was retrieved from Web of Science, PubMed, Cochrane, Embase, Google Scholar, and CNKI, up to July 31st, 2023. The methodological quality was evaluated using the Physiotherapy Evidence Database (PEDro) scale, and relevant data were systematically reviewed.

Results Fifteen researches were included, from nine countries, comprising 13 randomized controlled trials with the scores of PEDro scale from five to eight, involving 17 021 participants aged six to 18 years. They were published mainly from 2016 to 2023. The primary factors related to the intervention outcome were the age of participants, HIIT intervention programs, and work-to-rest ratio. HIIT significantly improved working memory and inhibitory control in healthy children, while it was limited for adolescents.

Conclusion HIIT can significantly improve inhibitory control and working memory in healthy children. Key factors related to the intervention outcomes include the age of participants and the specifics of the HIIT program, etc.

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《Chinese Journal of Rehabilitation Theory and Practice》    2024, 30 (1): 0-0.  
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Effect of exercise rehabilitation and adapted physical activity on psychomotor skills, motor abilities and motor development in children and adolescents with spastic cerebral palsy: an evidence-based research using ICF
WU Liang, XU Xiu, LUO Liang
Chinese Journal of Rehabilitation Theory and Practice    2024, 30 (2): 148-156.   DOI: 10.3969/j.issn.1006-9771.2024.02.003
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Objective To systematically review the evidences of impact of exercise rehabilitation and adapted physical activity on psychomotor skills, motor abilities, and motor development in children with spastic cerebral palsy (CP).
Methods Relevant literature was retrieved from PubMed, Embase, Web of Science and CNKI, from January, 2010 to June, 2023. The contents were coded using International Classification of Diseases, Eleventh Revision, and International Classification of Functioning, Disability and Health; and evidences were analyzed with theoretical framework and code of ICD-11 and ICF.
Results A total of nine articles were included, from Denmark, South Korea, Australia, Saudi Arabia, Ghana, India and Japan, published from 2015 to 2022. The intervention programs primarily involved exercise rehabilitation (including physical therapy) and adapted physical activity. Exercise rehabilitation included upper limb strength training, lower limb strength training, balance and coordination training, gait training, functional aerobic exercise, stretching and flexibility exercises, flexibility training, muscle relaxation techniques; ten to 50 minutes a time, two to six times a week,with the intensity of low to high, for six to 20 weeks. Adapted physical activities mainly involved adapted running training, virtual games; 60 minutes a time, two to four times a week, with the intensity of medium to high, for six to twelve weeks. Interventions primarily took place in medical and rehabilitation institutions, schools, and home-based communities, with professionals including occupational physical therapists, university researchers, community health personnel and teachers. The outcomes were mainly reflected in four aspects: psychomotor skills, motor abilities, motor development, and quality of life and well-being. In terms of psychomotor skills, adolescents with CP mastered running techniques and knowledge, and enhanced their response to balance threats. In terms of motor abilities, adolescents with CP showed an increase in muscle strength, enhanced muscle endurance, and an expansion of muscle tone; improvements in gait functionality, walking ability, and gait symmetry; increases in walking endurance; improvements in standing function; and improvements in dynamic balance; as well as enhanced control over balance posture. In terms of motor development, there was a significant improvement in activities of daily living, participation levels in school and leisure activities during free time, and an expanded range of motion. In terms of quality of life and well-being, adolescents with CP showed significant enhancements in self-confidence and self-esteem, significant relief from (spastic) pain, and improvements in social well-being and acceptance.
Conclusion This systematic review has synthesized the evidences of benefits of exercise rehabilitation and adapted physical activity on the psychomotor skills, motor abilities and motor development of children and adolescents with spastic CP. In terms of psychomotor skills, exercise rehabilitation and adapted physical activity help to improve the cognitive and motor skills of adolescents with spastic CP. In terms of motor abilities, exercise rehabilitation and adapted physical activity can improve muscle-related functions, gait and walking abilities, as well as balance and coordination. In terms of motor development, exercise rehabilitation and adapted physical activity significantly enhance activities of daily living and the level of participation in leisure physical activities. Finally, exercise rehabilitation and adapted physical activity can increase energy and motivation, alleviate pain, and enhance social well-being and acceptance.

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Psychological and behavioral characteristics of children with autism spectrum disorder using Psycho-educational Profile (Third Edition)
GENG Limeng, LIU Congcong, LI Ling, LÜ Panpan, WANG Xin, LIU Fang
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (9): 1035-1039.   DOI: 10.3969/j.issn.1006-9771.2023.09.006
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Objective To explore psychological and behavioral characteristics of children with autism spectrum disorder (ASD) using Psycho-educational Profile (Third Edition) (PEP3).

Methods From October, 2021 to October, 2022, 192 children with ASD without intervention in the Binzhou Medical University Hospital were selected as observation group, and 96 healthy children who visited at the same time were selected as control group. They were assessed with PEP3.

Results The development of receptive language significantly delayed behind expressive language (t = 5.383, P < 0.001) in the observation group. The cognitive, expressive language, receptive language, fine motor, gross motor, imitation and personal self-care correlated with age (r = 0.540 to 0.795, P < 0.001). The Cronbach's α of PEP3 for the observation group was 0.810 to 0.947. The original score of each subtest of PEP3 was less in the observation group than in the control group (|t| > 4.267, P < 0.001).

Conclusion The development of receptive language retards behind the expressive language in children with ASD. Cognitive and motor functions develop with age, while the correlation between maladaptive behavior and age is weak. PEP3 is reliable in internal consistency, and valid in discrimination.

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Application of artificial intelligence in anxiety and depression among children and adolescents: a scoping review
SU Rufeng, ZHONG Xiaoke, GAO Xiaoyan, JIANG Changhao
Chinese Journal of Rehabilitation Theory and Practice    2024, 30 (5): 513-519.   DOI: 10.3969/j.issn.1006-9771.2024.05.003
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Objective To review the application of artificial intelligence in anxiety and depression among children and adolescents.

Methods PubMed, Web of Science, CNKI and Wanfang data were searched for literature related to artificial intelligence applied in of anxiety and depression among children and adolescents from January, 2014 to January, 2024, and a scoping review was conducted.

Results A total of ten papers were included, originating from the United States, China, Australia and France. These researches were primarily published in journals related to psychology, public health, clinical medicine, neuroscience and rehabilitation, involving six cross-sectional researches, three longitudinal researches and one interview, including 10 880 participants aged from three to 18 years. The types of data mainly included questionnaires/scales, interview data and brain imaging data. Features related to anxiety and depression were extracted from the data, and artificial intelligence were employed to develop models for the identification or prediction of anxiety and depression in children and adolescents.

Conclusion Artificial intelligence is potential for identifying or predicting anxiety and depression in children and adolescents.

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Difference of cervical and shoulder muscle performance and its correlation with pain and body mass index in patients with chronic neck pain
SHEN Xingxing, XIONG Yuling, CHEN Weijian, LI Congcong, LI Junyi, WANG Shuai, ZHANG Jiahao, XIANG Ruian, CHEN Jiahao, LIU Wengang, XU Xuemeng
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (12): 1420-1428.   DOI: 10.3969/j.issn.1006-9771.2023.12.006
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Objective To test the inter-tester reliability and test-retest reliability of MyotonPRO for evaluating neck and shoulder muscle performance parameters in patients with unilateral chronic neck pain, observe the difference of muscle performance between the healthy and affected sides of patients with chronic neck pain, and analyze the factors that cause the imbalance of muscle performance in patients with chronic neck pain.

Methods From January to June, 2023, 32 patients with unilateral chronic neck pain in Guangdong Second Traditional Chinese Medicine Hospital were selected. Two testers used the same MyotonPRO equipment to measure the muscle tone, muscle hardness and muscle elasticity on both sides of the sternocleidomastoid muscle and the upper trapezius muscle in the relaxed position. Tester 1 repeated the measurement after an interval of 30 minutes, and Tester 2 was measured within the time interval between the two measurements of Tester 1. The intraclass correlation coefficient (ICC), standard error of mean (SEM) and minimum detectable change (MDC) were calculated simultaneously. The measurement results were plotted into Bland-Altman diagram and systematic bias analysis was performed. The difference in muscle characteristics between the affected side and the healthy side was compared. At the same time, the Visual Analogue Scale (VAS) score and body mass index (BMI) of the subjects were collected for correlation analysis.

Results Except the sternocleidomastoid muscle elasticity of the affected side (ICC = 0.697), the inter-tester reliability of all other parameters was high to very high (ICC = 0.719 to 0.952, SEM = 0.04 to 6.53, MDC = 0.12 to 18.11). The test-retest reliability of all parameters was high (ICC = 0.883 to 0.981, SEM = 0.03 to 5.72, MDC = 0.09 to 15.84). Bland-Altman plot analysis showed that the scatter distribution was consistent. The muscle tone, muscle hardness and muscle elasticity of sternocleidomastoid muscle and upper trapezius muscle were higher on the affected side than on the healthy side (t > 2.846, P< 0.05). The asymmetry index of tension, hardness and elasticity of upper trapezius muscle and sternocleidomastoid muscle was significantly positively correlated with VAS score and BMI (r> 0.385, P< 0.05).

Conclusion MyotonPRO has good inter-tester reliability and retest reliability in evaluating the muscle performance of both sides of patients with chronic neck pain. The muscle tone, muscle hardness and muscle elasticity of sternocleidomastoid muscle and upper trapezius muscle on the affected side were higher than on the healthy side, and the difference of muscle performance was positively correlated with pain and BMI.

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Comparative effect of different neuromuscular exercises on pain and motor function of knee in patients with early knee osteoarthritis
ZHANG Guancong, HUANG Qiuchen, GU Rui, LIU Sihai, HU Chunying, LIU Kemin
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (9): 1090-1097.   DOI: 10.3969/j.issn.1006-9771.2023.09.013
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Objective To compare the effect of proprioceptive neuromuscular training methods on pain and motor ability of knee in patients with early knee osteoarthritis (KOA).

Methods From November, 2022 to May, 2023, 60 early KOA patients from Beijing Bo'ai Hospital and community were randomly divided into groups A, B and C, with 20 patients in each group. Group A received proprioceptive neuromuscular facilitation (PNF), group B received neuromuscular exercise (NEMEX), and group C received PNF and NEMEX, for six weeks. They were assessed with Visual Analogue Scale for pain (VAS), angle reappearance test, difference of pre-motor reaction time (VM-VL), active range of motion (AROM) of knee flexion, 10-meter walk test (10MWT), and Knee Injury and Osteoarthritis Outcome Score (KOOS) before and after treatment.

Results All the indexes improved in all the groups after treatment (|t| > 2.532, P < 0.05). Among the groups, the VAS score was the least in group A, and then groups C and B; the angle reappearance error was the least in group C, and similar in groups A and B; the VM-VL was the least in groups A and C, followed by group B.

Conclusion PNF, NEMEX and PNF+NEMEX can relieve the pain and improve the motor function of knee in patients with early KOA, however, PNF is the most effective on relieving pain, and PNF+NEMEX is the most effective on improving knee function.

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Characteristics of interbrain synchrony during interactions among individuals with autism spectrum disorder: a scoping review
WU Jinlong, REN Zhanbing, YI Zizhen, PENG Li
Chinese Journal of Rehabilitation Theory and Practice    2024, 30 (2): 168-175.   DOI: 10.3969/j.issn.1006-9771.2024.02.005
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Objective To review the characteristics of interbrain synchrony between individuals with autism spectrum disorder (ASD) and healthy individuals during interactions.
Methods Researches on interbrain synchrony during interactions in individuals with ASD were retrieved from databases such as PubMed, Web of Science, Scopus and CNKI in November, 2023. Researches were screened and the relevant data were extracted. The quality of the methodology was evaluated using critical appraisal tool for analytic cross sectional study.
Results Five researches were returned, publicated mainly from 2020 to 2023, including 130 individuals with ASD. Interbrain synchrony was lower during the interaction task in the individuals with ASD compared with the healthy, mainly involving the prefrontal and temporo-parietal joint regions; as well as the interbrain synchrony of theta, alpha and beta bands of electroencephalography. There was difference in interbrain synchrony between genders in individuals with ASD; furthermore, abnormal interbrain synchrony in individuals with ASD associated with social impairment.
Conclusion Interbrain synchrony deficits may be a potential neural mechanism for social impairment in individuals with ASD, and the abnormalities mainly happen in the brain areas related with mirror nervous system and theories of mind network.

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Effect of psychological intervention on anxiety or depression in children and adolescents with hearing impairment: a systematic review
ZHANG Jingya, ZOU Min, SUN Hongwei, SUN Changlong, ZHU Juntong
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (9): 1004-1011.   DOI: 10.3969/j.issn.1006-9771.2023.09.002
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Objective To systematically review the effect of psychological intervention on anxiety and depression in hearing-impaired children and adolescents.

Methods The literature was researched from the databases of PubMed, Web of Science, Embase, CNKI, and Wanfang Database on psychological intervention on anxiety and depression for hearing-impaired children and adolescents until July, 2023. After screening, author, country, study object, study design, intervention mode, outcome, and measurement tools were extracted from the literature.

Results Eight articles from three countries were included, including eight randomized controlled trials, involving 404 participants, publishing mainly from 2013 to 2023. The types of psychological intervention included family support education, emotional intelligence training, cognitive behavioral therapy, self-confidence group training, and play therapy, and so on, which improved social phobia, and relieved the levels of anxiety and depression of children and adolescents with hearing impairment.

Conclusion Psychological intervention can effectively alleviate the anxiety and depression of children and adolescents with hearing impairment.

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Effect of acupuncture on children with attention deficit hyperactivity disorder
WANG Yan, JIN Longtao
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (5): 615-620.   DOI: 10.3969/j.issn.1006-9771.2023.05.019
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Objective To observe the effect of acupuncture on children with attention deficit hyperactivity disorder (ADHD).

Methods From August to December, 2022, 54 children with ADHD from the outpatient clinic of the Fourth People's Affiliated Hospital of Jiangsu University were randomly divided into control group (n = 27) and observation group (n = 27). All the patients accepted electroencephalogram (EEG) neurofeedback training, while the observation group accepted acupuncture in addition, for twelve weeks. They were assessed with Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), Conners Parent Symptom Questionnaire (PSQ), and EEG before and after treatment.

Results The comprehensive control quotient, comprehensive attention quotient and hyperactivity quotient of IVA-CPT increased in the observation group after treatment (t > 3.889, P < 0.001), and they were more in the observation group than in the control group (t > 2.040, P < 0.05); while all the factors of PSQ reduced in the observation group (t > 6.630, P < 0.001), and they were less in the observation group than in the control group (t > 3.871, P < 0.001); the mean frequency of β and sensorimotor rhythms increased in the observation group (t > 12.432, P < 0.001), and they were more in the observation group than in the control group (t > 7.561, P < 0.001); the mean frequency of θ reduced in the observation group (t = 9.966, P < 0.001), and it was less in the observation group than in the control group (t = 7.257, P < 0.001).

Conclusion Combination of acupuncture is more effective on EEG in children with ADHD to improve attention, control and core symptoms.

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Relationship between lower limb muscle strength and walk speed in community dwelling older adults: the chain mediating role of flexibility and dynamic balance
TAN Xiaohuan, JIANG Guiping, HUANG Xinyi, WANG Dandan, ZHANG Lei, BU Qingguo, WU Xueping
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (6): 646-653.   DOI: 10.3969/j.issn.1006-9771.2023.06.004
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Objective To investigate the relationship between lower limb muscle strength and walking speed in older adults, and to analyze the mediating role of flexibility and dynamic balance.
Methods From November to December, 2021, a total of 155 older adults at the Shanghai Senior Sports and Health Home were included. Their basic health information was collected, and the lower limb muscle strength, flexibility, dynamic balance and walking speed were tested. A mediated effects analysis was conducted.
Results There was a pairwise correlation among lower limb muscle strength, flexibility, dynamic balance and walking speed in older adults (r > 0.210, P < 0.01). In the mediated effects model, after controlling for age and gender, lower limb muscle strength did not directly predict walking speed in older adults (β = 0.029, P = 0.699), however, lower limb muscle strength could influence walking speed through the partial mediation of dynamic balance (effect = 0.0130, 95% CI 0.0073~0.0197) and the chain mediation of lower flexibility and dynamic balance (effect = 0.0019, 95% CI 0.0003~0.0043).
Conclusion Lower limb muscle strength can indirectly affect walking speed in older adults through the mediators of flexibility and dynamic balance, or the dynamic balance alone.

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《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (9): 0-0.  
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Research on framework, core content and priority areas of international policy of healthcare, rehabilitation and education services for children with hearing and speech impairments
ZHANG Qing, LI Yanqun, JIA Wenrong, LIU Qiaoyun, JIANG Ruilin
Chinese Journal of Rehabilitation Theory and Practice    2024, 30 (4): 373-380.   DOI: 10.3969/j.issn.1006-9771.2024.04.001
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Objective To analyze the framework, core content and priority development areas of international policy concerning healthcare, rehabilitation and educational services for children with hearing and speech impairments.

Methods Based on the WHO's "Rehabilitation in Health Systems" and the six building blocks of health services, this study conducted a systematic analysis of the international policy framework, core content and priority areas for global healthcare, rehabilitation and education services for children with hearing and speech impairments, with reference to the WHO World Report on Hearing.

Results Regarding leadership and governance, an inter-sectoral governance system and capabilities are necessary, formed through inclusive policy-making and collaborative planning with all stakeholders to enhance ear and hearing health initiatives. In the area of financing, sustainable funding and health protection policies are vital, advocating for incremental annual investments to broaden the scope of ear and hearing healthcare services. Human resources development calls for bolstering educational and training initiatives, expanding programs for ear and hearing healthcare, speech therapy and special education professionals, to elevate service delivery proficiency. For service provision, establishing an integrated, person-centered ear and hearing care system is advocated, which weaves ear and hearing care interventions into comprehensive health strategies, acknowledging the necessities and priorities across all levels and establishing an inclusive service system in the realms of children's healthcare, rehabilitation and education. In terms of medical technology and infrastructure, the study encourages the facilitation of high-caliber hearing technologies, emphasizing the efficacy and cost-effectiveness of devices like hearing aids and cochlear implants, and fully incorporating assistive and accessible technologies into educational and rehabilitative practices to improve the comprehensive care of children with hearing loss. Digital technologies' proliferation within children's healthcare, rehabilitation and educational services is also encouraged. In the field of information systems and monitoring, the development of standardized monitoring metrics and the establishment of evaluation mechanisms for hearing healthcare services are proposed, promoting remote surveillance and services. For rehabilitation and education, the establishment of a unified monitoring data platform to augment the quality of hearing and speech rehabilitation services for children is suggested. The WHO delineates five international priority development areas for healthcare, rehabilitation, and educational services for children with hearing and speech impairments, namely early intervention and education, hearing and speech therapy, psychosocial support, social skills and community participation, and vocational education and life skills training.

Conclusion Based on the six components of the health service system, this study systematically analyzed the international policies of health care, rehabilitation and education services for hearing-impaired and speech-impaired children, and constructed the service structure and core contents of health care, rehabilitation and education services for them. Under the vision of WHO health service system, the development of hearing-impaired health and rehabilitation, and the construction of hearing-impaired health and rehabilitation service system should focus on five areas: early intervention and education, hearing and speech therapy, psychosocial support, social skills and community participation, and vocational education and life skills training.

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Effect of intervention based on theory of planned behavior on muscle attenuation and balance of the elderly with sarcopenia
YANG Ya'nan, MU Liping, XING Fengmei, XUE Xinhong, WANG Xiaoguang, TAO Yangyu, SUN Zhumei, ZHANG Xiaoli
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (8): 869-874.   DOI: 10.3969/j.issn.1006-9771.2023.08.001
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Objective To explore the effect of intervention based on theory of planned behavior on muscle attenuation and balance of the elderly with sarcopenia.
Methods From September, 2022 to February, 2023, 124 elderly people with sarcopenia were conveniently sampled from Lishuiwan Community and Shuxiangyuan Community in Shijiazhuang City, Hebei Province. According to the coin toss, 62 elderly people from Shuxiangyuan Community were designated as control group, and 62 elderly people from Lishuiwan Community were as intervention group. The intervention group implemented the intervention based on the theory of planned behavior, including behavior attitude, behavior, subjective norms, perceived behavior control and behavior awareness; the control group maintained their original lifestyle, for twelve weeks. Before and after intervention, the grip strength, time of Five-Times-Sit-to-Stand Test, relative appendicular skeletal muscle index (RASM), 6-minute walking speed and the score of Berg Balance Scale (BBS) were compared.
Results After intervention, the grip strength, RASM, 6-minute walking speed, and the score of BBS significantly increased, and the time of Five-Times-Sit-to-Stand Test shortened in the intervention group (|Z| > 6.257, |t| > 28.643, P < 0.001), and they were better in the intervention group than in the control group (|Z| > 2.288, |t| > 3.177, P < 0.05).
Conclusion The intervention based on theory of planned behavior can effectively relieve the muscle attenuation of the elderly with sarcopenia, and improve their balance ability.

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Expert consensus on rehabilitation and management of airway function for neurocritical patients with tracheotomy (2024)
Committee of Neurological Rehabilitation, China Association of Rehabilitation of Disabled Persons, China Rehabilitation Research Center
Chinese Journal of Rehabilitation Theory and Practice    2024, 30 (8): 869-881.   DOI: 10.3969/j.issn.1006-9771.2024.08.001
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Objective To create an evidence-based expert consensus on airway function rehabilitation and management post tracheostomy in neurocritical patients.

Methods The lists of problems and recommendations were defined using Delphi method, and the evidence quality and recommendation strength were evaluated using GRADE, and the results were reported based on RIGHT.

Results The comprehensive rehabilitation of airway function for neurocritical patients with tracheotomy in the setting of clinical rehabilitation would be conducted by a multidisciplinary team, including rehabilitation physicians, rehabilitation therapists, nurses, etc. A total of 17 recommendations were finally formulated on four major issues, including the airway function rehabilitation, airway management, pre-decannulation assessment and decannulation, and the monitoring after decannulation and rehabilitation management.

Conclusions The expert consensus on the airway function rehabilitation and the management after tracheostomy in neurocritical patients in the setting of clinical rehabilitation has been created, which may be helpful for the quality and safety of rehabilitation for the airway function in neurocritical patients with tracheostomy.

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Effect of cognitively engaging physical activity on developing executive function of children and adolescents: a systematic review based on ICF
WEN Jianing, JIN Qiuyan, ZHANG Qi, LI Jie, SI Qi
《Chinese Journal of Rehabilitation Theory and Practice》    2024, 30 (1): 44-53.   DOI: 10.3969/j.issn.1006-9771.2024.01.006
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Objective To systematically review the intervention effect of cognitively engaging physical activity (CEPA) on executive function of children and adolescents.

Methods Literatures in Chinese and English were retrieved from databases of Web of Science, PubMed, Medline, EBSCO and CNKI, from the establishment to November 30th, 2023. According to the inclusion and exclusion criteria, the literatures that met the requirements were screened, and their quality was evaluated and systematically reviewed.

Results A total of 15 literatures were included, published between 2014 and 2023, from eight countries, involving 1 806 subjects aged four to 16 years. The average score of PEDro scale was 6.6. The intensity of the CEPA intervention ranged from 64% to 93% HRmax, the duration of a single session ranged from ten to 60 minutes, and the frequency of the intervention was two to five sessions a week, for four to 24 weeks. Specific forms of CEPA included football, basketball and floorball combined with cognitive tasks; running, jumping, squatting, sitting, spinning and balancing combined with cognitive tasks; and exergaming combined with cognitive tasks. Eleven researches showed positive effects of CEPA intervention on at least one component of executive function. However, six of the seven researches involving working memory failed to verify the positive effects. Twelve researches compared the intervention effects of CEPA and rutine exercise or regular physical education classes, and nine researches found that CEPA was more effective on executive function.

Conclusion The CEPA is effective on the executive function of children and adolescents, specifically on cognitive flexibility; it shows inconsistent effects on inhibitory control, and its effect on working memory has not been verified. The intervention types of CEPA are divided into ball games combined with cognitive tasks, basic motor skills training combined with cognitive tasks, and exergaming combined with cognitive tasks.

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Psychosocial intervention and mental health for older adults: a systematic review
TANG Jiayu, QIU Fubing
《Chinese Journal of Rehabilitation Theory and Practice》    2023, 29 (10): 1164-1170.   DOI: 10.3969/j.issn.1006-9771.2023.10.007
Abstract338)   HTML29)    PDF(pc) (1114KB)(359)       Save

Objective To systematically review the effects of psychosocial support-related activities on mental health of older adults.
Methods Randomized controlled trails (RCTs) on mental health benefits for older adults were retrieved from PubMed, Web of Science, EBSCO and CNKI, until August, 2022. A systematic review was conducted.
Results Seven RCTs were included, from Spain, Chile, Canada, Finland, the United Kingdom, South Korea and the United States, mainly from psychiatry, mental health of the elderly and other journals, published after 2017. The subjects aged 60 to 80 years, accounting to 1 258 cases. Psychosocial interventions included Pilates, mindfulness, behavioral activation, cognitive stimulation, daily difficult problem solving training, pain and depression symptom management, health education and guidance, nursing coordination, group exercise (such as circuit training, pedal training or rubber band training), and water sports, etc. The frequency of intervention was 30 to 120 minutes a time, one to nine times a week, and the intensity of the intervention was low to high intensity for four to 64 weeks. Intervention sites included sports venues, community health centres, ageing services, and intervention staff included sports therapists (yoga), psychologists, health professionals, community health services, and health care workers. All interventions were carried out under supervision. The benefits of psychosocial intervention on the mental health of the older adults mainly reflected in the improving cognitive function and self-efficacy, reducing anxiety and depression, improving depressed mood or loneliness, improving sleep quality, increasing sense of social integration and relieving pain and other problems.
Conclusion Mental health interventions (psychological interventions or support, social interventions or support, psychosocial interventions) and mental health-related interventions (physical activity interventions) benefit older people's mental health, including improving cognitive function, alleviating anxiety and depression, improving sleep quality, and improving quality of life and well-being.

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